Individual
MRS. PAMELA DIANNE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14344 GRANDVILLE AVE, DETROIT, MI 48223-2943
(313) 704-3980
Mailing address
14344 GRANDVILLE AVE, DETROIT, MI 48223-2943
(313) 704-3980
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
D423676143597
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247200000X
ADD TAXONOMY
MI
01
—
247200000X/TECHNICIA
ADD TAXONOMY
MI
05
—
247200000X/TECHNICIA
—
MI
Enumeration date
07/23/2016
Last updated
07/23/2016
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